Derek Mantey, MS, ATC, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

10299 Issued in CA

Practice address

31461 Rancho Viejo Rd
Suite 101
San Juan Capistrano, CA 92675-1864

Phone

(949) 542-5000

Fax

(949) 419-2650

NPI assigned

Jan 15, 2014

Last updated

Jan 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fullmotion Physical Therapy PC

  • Physical Therapy Clinic/Center
  • San Juan Capistrano, CA
  • NPI 1831357367
  NPD (past)
• Gleason Physical Therapy Inc.

  dba FreeMotion Physical Therapy

  • Physical Therapy Clinic/Center
  • San Juan Capistrano, CA
  • NPI 1366771602
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1790107365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31461 RANCHO VIEJO RD",
            "address_2": "SUITE 101",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751864",
            "telephone_number": "949-542-5000",
            "fax_number": "949-419-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31461 RANCHO VIEJO RD",
            "address_2": "SUITE 101",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751864",
            "telephone_number": "949-542-5000",
            "fax_number": "949-419-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTEY",
        "first_name": "DEREK",
        "credential": "MS, ATC, PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "10299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallery Dental Corporation (Capistrano Dental Group)
• Mary Claire Malooly, PT, DPT, ATC
• Jose Luis Mancilla Jr.
• Pat Anne Mann, M.A.
• Jennifer Rebecca Mansoor
• Marcum Psychological Services Corp
• Maria Theresa Baylon-D'Souza (Flex Physical Therapy)
• Mariam Soldin-Wasfi DMD Professional Corp
• Valerie Marinko, RPH
• Mariposa Women and Family Center (ADAS Mariposa Women's Center CalWorks San Juan Capistrano)

• Physical Therapy Assistant in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.